Course:SPPH381B/TermProject/The Red Solo Cup/Hazards in the Trucking Industry

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Introduction

Trucking is a difficult job as it requires workers to have irregular schedules, work long hours, participate in little physical activity, have limited access to healthy foods, as well as be in high stress situations[1]. Truckers are also at a higher risk of musculoskeletal strains, exposure to carcinogenic substances, asthma, psychological distress and psychiatric disorders, hypertension, stroke, substance misuse, gambling, assaults, robberies, and violence[2]. The life expectancy of truck drivers ranges from 56 to 63 years, which is low when compared to the population male average of 77 years[2].

Lung Cancer due to Diesel Exposure

The international agency for research on cancer has classified diesel as carcinogenic to humans (Group 1) [3]. Diesel exhaust has been related to sufficient cases of cancer, especially lung, to be classified as such[3]. Diesel exhaust includes mutagenic and polycyclic aromatic hydrocarbon carcinogenic compounds[4]. Chronic exposures to diesel exhaust, as experienced by truckers has been correlated to risk of lung cancer[5]. The main route of exposure is through inhalation; however, skin and eye contact is also known to cause acute irritation[6]. NIOSH prescribes no REL, which follows a policy for “no detectable exposure levels for proven carcinogenic substances”[7].

Obesity

The trucking industry creates many barriers to the worker attaining a healthy lifestyle which leads to excess weight-gain and the health repercussion associated with it. 87.3% of truckers are either overweight or obese[2]. Transportation environment, government regulations, corporate policies, and the built environment all have a role in elevating truckers’ risk for obesity[2]. Irregular sleep patterns are correlated with weight gain as they cause metabolic changes, fried foods and animal fat were also found to be the most common and preferred dietary selection, and only 15% of the studied sample consumed the recommended servings of fruit and vegetables[2]. The infrastructure that has been built around the routes that are driven by truckers adds to the poor diet of truckers as it does not support the ingestions of proper nutrition, nor an opportunity to be physically active[2]. The environment that the truckers work in does not promote healthful behaviours, changing this environment would be an effective mean of improving the health of workers in the trucking industry[2].

Fatigue

Fatigue is a critical problem for drivers in the trucking industry, 47% of long distance truckers reported falling asleep at the wheel during their driving career[8]. The operation of a vehicle requires sustained vigilance, excellent judgment, and quick reaction times and fatigue impairs these abilities which endangers the driver as well as other road users[8]. One study found that drivers slept only an average of 4.78 hours per day, this lack of sleep is due to long work hours, disturbances in circadian rhythm, and available sleeping conditions[8]. Sleep deprivation has the ability to cause neurobehavioral impairments equivalent to a blood alcohol level of 0.05 to 0.10 which are illegal limits[8].

Exposure to UV (solar) radiation

Ultraviolet rays are a part of sunlight and can penetrate and change the structure of skin cells[9]. Sunlight exposure is highest during the summer and is the most intense between 10am and 4pm[9]. Long term sun exposure results in characteristic changes of the skin, these include, wrinkles, roughness, and sallowness and are called photodamage[10], when these characteristics are only found on one side of the face, as often occurs with drivers, it is called unilateral dermatoheliosis[11].

Recognition

Unilateral dermatoheliosis

As truckers spend their working hours driving, they are exposed to more sunlight to their left side than the general population and thus are at increased risk of developing skin cancer, particularly of the side of their body exposed to sunlight (the left side) [12]. Damage associated with UV exposure is more common on the driver side hands and forearms than the opposite side and is increased in those older than 40 years and with an occupation duration greater than 10 years[12]. There is an increase of left-sided photodamage as percentage of time spent driving increases[10]. In 2012 a case of unilateral dermatoheliosis was presented examining a 69-year-old man who had been a truck diver for 28 years[11]. Although there is a correlation between occupation and skin cancer or damage such as photoaging, it is difficult to verify the connection as there is a long period between exposure and development of the damage[13].

Evaluation

A prevalent source of UV exposure is driving[14]. In Australia, there have been more cases of damage from UV rays on the right side of the body whereas in the United States there have been more cases on the left side of the body, this is due to the side of the car the respective drivers sit on and the greatest dose was on the arm of the side exposed to sunlight[14]. UV radiation has been shown to increase gene expression, supress immune reactions, and induce antigen tolerance, which can lead to tumor promotion, and eventually skin cancer[15]. NIOSH recommends that to protect themselves from UV damage, workers should wear sunscreen with a minimum SPF of 15, applied at least 20 minutes before sun exposure, and that it should be reapplied every two hours or each time the individual gets out of the water or sweats heavily[16].

Controls

Use of sunscreen as well as oral intake or topical use of antioxidants, and wearing hats, sunglasses, and appropriate clothing may be effective in preventing photoaging and skin cancer development [15][13]. To ensure that proper protocol is followed, the workers must be educated and legislation must be employed[13]. Another method to lower the risk of UV-related damage to truck drivers can involve the use of UV-absorbing film to the window of the vehicles, this has been shown to reduce UV transmission by 99.6%[17]. Front windshields are made of a laminated glass, by law, to reduce ejection from the vehicles, and this lamination blocks the majority of UV rays[18]. However, side windows are mostly made up of tempered glass which does not block UV rays very well[18]. A solution for this may be to apply aftermarket window films to these side window to reduce exposure to UV rays; the addition of these films to tempered glass has resulted in a 99% reduction in the transmission of UV rays[18]. The concern with this technique is that it is only effective if the window remains shut for the duration of the driver’s shift, which may not occur.

References

  1. ↑ https://www.cdc.gov/niosh/topics/truck/
  2. ↑ 2.0 2.1 2.2 2.3 2.4 2.5 2.6 Apostolopoulos, Y., Sönmez, S., Shattell, M., & Belzer, M. H. (2012). Environmental determinants of obesity-associated morbidity risks for truckers. International Journal of Workplace Health Management, 5(2), 120-138.
  3. ↑ 3.0 3.1 https://www.iarc.fr/en/media-centre/pr/2012/pdfs/pr213_E.pdf
  4. ↑ Garshick, E., Laden, F., Hart, J. E., Rosner, B., Davis, M. E., Eisen, E. A., & Smith, T. J. (2008). Lung cancer and vehicle exhaust in trucking industry workers. Environmental Health Perspectives, 116(10), 1327
  5. ↑ Steenland, K., Deddens, J., & Stayner, L. (1998). Diesel exhaust and lung cancer in the trucking industry: exposure–response analyses and risk assessment. American Journal of Industrial Medicine, 34(3), 220-228
  6. ↑ https://www.cdc.gov/niosh/npg/npgd0207.html
  7. ↑ https://www.cdc.gov/niosh/npg/nengapdxa.html
  8. ↑ 8.0 8.1 8.2 8.3 https://www.cdc.gov/niosh/docs/2007-120/pdfs/2007-120.pdf
  9. ↑ 9.0 9.1 https://www.cdc.gov/niosh/topics/sunexposure/default.html
  10. ↑ 10.0 10.1 Singer, R. S., Hamilton, T. A., Voorhees, J. J., & Griffiths, C. E. (1994). Association of asymmetrical facial photodamage with automobile driving. Archives of dermatology, 130(1), 121-123.
  11. ↑ 11.0 11.1 Gordon, J. R., & Brieva, J. C. (2012). Unilateral dermatoheliosis. N Engl J Med, 366, e25
  12. ↑ 12.0 12.1 Kavak, A., Parlak, A. H., Yesildal, N., Aydogan, I., & Anul, H. (2008). Preliminary study among truck drivers in Turkey: effects of ultraviolet light on some skin entities. The Journal of dermatology, 35(3), 146-150
  13. ↑ 13.0 13.1 13.2 Gruber, F., Peharda, V., Kaštelan, M., & Brajac, I. (2007). Occupational skin diseases caused by UV radiation. Acta Dermatovenerologica Croatica, 15(3), 0-0
  14. ↑ 14.0 14.1 Paulson, K. G., Iyer, J. G., & Nghiem, P. (2011). Asymmetric lateral distribution of melanoma and Merkel cell carcinoma in the United States. Journal of the American Academy of Dermatology, 65(1), 35-39
  15. ↑ 15.0 15.1 Ichihashi, M., Ueda, M., Budiyanto, A., Bito, T., Oka, M., Fukunaga, M., ... & Horikawa, T. (2003). UV-induced skin damage. Toxicology, 189(1), 21-39
  16. ↑ https://www.cdc.gov/niosh/topics/sunexposure/recommendations.html
  17. ↑ Bernstein, E. F., Schwartz, M., Viehmeyer, R., Arocena, M. S., Sambuco, C. P., & Ksenzenko, S. M. (2006). Measurement of protection afforded by ultraviolet‐absorbing window film using an in vitro model of photodamage. Lasers in surgery and medicine, 38(4), 337-342
  18. ↑ 18.0 18.1 18.2 Almutawa, F., Vandal, R., Wang, S. Q., & Lim, H. W. (2013). Current status of photoprotection by window glass, automobile glass, window films, and sunglasses. Photodermatology, photoimmunology & photomedicine, 29(2), 65-72.
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